Physicians: Infection Prevention is in YOUR Hands

YOUR responsibility to:Protect YOUR Patients

Protect YOURSELF

Chain of Infection

Natural body openingsMan-made body openings

MRSA

YOU

PATIENT

Contact

AirborneDroplet

Percutanous

Stool

Wounds

HANDSTB

Flu Catheter

Mouth

Nose

Incision XEnvironment

Sputum

Health Care-Associated Infection (HAI) in the USA

• An estimated 722,000 HAIs in U.S. acute care hospitals during 2011 – On any given day, ~1 in 25 hospital patients had an HAI

• ~ 75,000 HAI associated deaths – 1 out of 10 patients with an HAI died due to the infection

VRE

CARBAPENEM RESISTANT Acinetobacter

Resistant Pseudomonas

MRSA

Klebsiella (KPC)

MULTI-DRUG RESISTANT ORGANISMS (MDRO)

CRE

C. difficile

ESBL

PREVENTION of MDROs and HAIsAnd remember the “iceberg effect”

Hand HygieneStandard and Transmission-Based Precautions

Communication (and READ the signs!)Clean environmentAntibiotic StewardshipOrganizational goals for device associated infections

The Iceberg Effect

Your 5 Moments of Hand Hygiene

https://www.youtube.com/watch?v=MGpevGkaPcY&feature=related

Standard and Transmission-Based Precautions

• Barrier precautions or Personal Protective Equipment (PPE) for ALL patients when you anticipate contact with– body substances or fluids– non-intact skin – mucous membranes

• Taking precautions protects YOU against patients with – Known diagnosed or suspected infections and diseases– Unknown incubating diseases or colonized with infectious

organisms

Direct and Indirect Contact

Droplets, Splashes

Airborne

N95 Respirator: requires fit testing

PAPR: Powered Air Purifying Respirator

What’s wrong with these pictures??(note, staged scenarios)

Beware of fomitecontamination..

University of Utah HAI Prevention Goals• Catheter associated urinary tract infections

– AKA “CAUTI”

• Central line associated bloodstream infections– AKA “CLABSI”

• YOU are a critical team member in assessing the need for invasive devices– Be aware if a device is in place– Understand the indications for invasive devices– Communicate daily with the nurses and your attending

Indications for a Urinary Catheter

Indications for a Central Venous Catheter• Resuscitation • Hemodynamic monitoring• Vasopressors • Chemotherapy, TPN, or other caustic meds

– includes some antibiotics• Transvenous pacing• Plasmapheresis, apheresis, hemodialysis, continuous renal

replacement therapy (CRRT)• All peripheral access exhausted

Bloodborne Pathogen Exposure Risks• HBV

– 30% from a needle stick (10% chronic infection)– Effective vaccine– Effective post exposure treatment

• HCV– 3% from a needle stick (85% chronic infection)– No vaccine– No good post exposure (treat if become infected)

• HIV– 0.3% from a needle stick (100% chronic infection)– No vaccine– Effective post exposure treatment (get ASAP!)

Exposure to Blood or Body Fluids• PREVENTION!

– BSP, Hand Hygiene, PPE, Vaccination

• Go ASAP to the Work Wellness Center (WWC) during open hours, or

– ED if WWC closed, then follow up with WWC!

– Source patient testing by WWC or Nursing Supervisor

• Exposures in Community Clinics/other facilities

– most handled onsite, ask your Supervisor

• Complete Worker’s Comp form w/ your Supervisor & send to HR

• WWC confidentially evaluates & provides free follow-up or Rx based on CDC guidelines

EXTREME Care with all SharpsThe person who uses the sharp

puts it into the sharps container

NEVER recap, break or bend needles

BE AWARE OF YOUR

ENVIRONMENT

Link has policies, protocols, etc..

Questions? Call the Infection Prevention and Control Office at 581-2706